of women suffering from interstitial cystitis/bladder pain syndrome. (IC/BPS). Methods: The patients are women managed at tertiary care centres. (n=190).
Original research
Depression and catastrophizing predict suicidal ideation in tertiary care patients with interstitial cystitis/bladder pain syndrome Dean A. Tripp, PhD;1 J. Curtis Nickel, MD;1 Adrijana Krsmanovic, MSc;1 Michel Pontari, MD;2 Robert Moldwin, MD;3 Robert Mayer, MD;4 Lesley K. Carr, MD;5 Claire C. Yang, MD;6 Jorgen Nordling, MD7 Queen’s University, Kingston, ON, Canada; 2Temple University, Philadelphia, PA, United States; 3Hofstra University School of Medicine, New Hyde Park, NY, United States; 4Asante Physician Partners, Grants Pass, OR, United States; 5University of Toronto, Toronto, ON, Canada; 6University of Washington, Seattle, WA, United States; 7University of Copenhagen, Herlev, Denmark
1
Cite as: Can Urol Assoc J 2016;10(11-12):383-8. http://dx.doi.org/10.5489/cuaj.3892
Introduction
Abstract
Interstitial cystitis/bladder pain syndrome (IC/BPS) is a chronic urological condition characterized by chronic pain in the pelvic, abdominal, and lower back areas, accompanied by urinary urgency and frequency,1,2 with an unknown etiology and no standardized treatment.3 Due to its refractory nature, treatment is focused on symptom and pain management, with psychosocial risk factors like depression as a subordinate concern. Suicide is the grimmest possible outcome associated with depression, and chronic pain patients endorse greater suicidal ideation (SI) and attempt suicide at a four-fold higher risk than the general population.4 While chronic pain conditions are in themselves not considered life-threatening, SI is an indicator for suicide attempts. Indeed, patients with pain report greater SI,5 attempts,6 and completions.6,7 Only one study has reported a prevalence of SI among patients with IC/ BPS at 11%,8 with marital status and depression associated with SI over and above IC/BPS-related symptoms. It is noteworthy that Hepner et al did not evaluate new risk factors, such as catastrophizing, and they employed a community-based epidemiological sample of women who met criteria for RAND interstitial cystitis epidemiology (RICE) high-specificity case definition of IC/BPS,9 not a clinical sample with a physician-confirmed diagnosis. Alarmingly, 90% of unplanned and 60% of planned first suicide attempts occur within one year of the onset of SI,10 tertiary care patients show greater SI than primary care cases with abdominal-pelvic pathology,11 and IC/BPS patients report more depression than controls.12 As well, catastrophizing is a predictor of SI.13 This study examined an IC/BPS tertiary care sample and controls for SI and its biopsychosocial risk factors (i.e., depression, catastrophizing) while controlling for other medical symptoms (pain, urinary symptoms) and demographics. This study adds three novel aims to the urology literature: 1) to be the first estimate of SI point prevalence in
Introduction: We sought to evaluate psychosocial factors as predictors of suicidal ideation (SI) in a tertiary care outpatient sample of women suffering from interstitial cystitis/bladder pain syndrome (IC/BPS). Methods: The patients are women managed at tertiary care centres (n=190). Controls were recruited from the community (n=117). Both groups completed questionnaires on demographics, pain (McGill Pain Questionnaire), IC/BPS symptoms, and psychological variables. Univariate and multivariate hierarchical regression modelling was conducted to examine the strength of associations and unique effects of psychosocial variables on patient SI. Results: Compared to 6% in healthy controls, 23% of patients endorsed SI in the past two weeks. Correlations between SI, depression, and catastrophizing across controls and cases show that for controls, SI is associated with greater pain (0.31; p
